RxBlue 2009 PA Criteria

ACTIQ/FENTORA

ACTIQ®

FENTANYL CITRATE

FENTORA®

ALPHA-1 PROTEINASE INHIBITORS

ARALAST®

PROLASTIN®

ZEMAIRA®

AMEVIVE

AMEVIVE®

ANABOLIC STEROIDS

ANADROL-50®

OXANDRIN®

OXANDROLONE

ARANESP

ARANESP®

ARCALYST

ARCALYST®

AVONEX

AVONEX ADMINISTRATION PACK®

AVONEX®

B vs D - Part B versus Part D Coverage PA

ANZEMET®

AZASAN®

AZATHIOPRINE

CARIMUNE NF NANOFILTERED®

CELLCEPT®

CESAMET®

CYCLOPHOSPHAMIDE

CYCLOSPORINE

CYTOXAN®

DRONABINOL®

EMEND®

ENGERIX-B®

FLEBOGAMMA®

GAMASTAN S-D®

GAMMAGARD LIQUID®

GAMUNEX®

GENGRAF

GRANISETRON HCL

GRANISOL®

IMURAN®

IVEEGAM EN®

KYTRIL®

MARINOL®

METHOTREXATE

MYFORTIC®

NEORAL®

OCTAGAM®

ONDANSETRON HCL

ONDANSETRON ODT

PANGLOBULIN NF®

PANGLOBULIN®

PHENERGAN®

POLYGAM S-D®

PROGRAF®

PROMETHAZINE HCL

RAPAMUNE®

RECOMBIVAX HB®

SANDIMMUNE®

TREXALL®

ZOFRAN ODT®

ZOFRAN®

BETASERON

BETASERON®

BOTOX

BOTOX®

BYETTA

BYETTA®

CEREZYME

CEREZYME®

CIMZIA

CIMZIA®

COPAXONE

COPAXONE®

ENBREL

ENBREL®

EPOETIN/PROCRIT

EPOGEN®

PROCRIT®

FABRAZYME

FABRAZYME®

FORTEO

FORTEO®

GROWTH HORMONES

GENOTROPIN®

HUMATROPE®

NORDITROPIN NORDIFLEX®

NORDITROPIN®

NUTROPIN AQ®

NUTROPIN®

OMNITROPE®

SAIZEN®

SEROSTIM®

TEV-TROPIN®

ZORBTIVE®

HUMIRA

HUMIRA®

INCRELEX

INCRELEX®

KINERET

KINERET®

LAMISIL

LAMISIL®

TERBINAFINE HCL

LEUPROLIDE (LONG ACTING)

ELIGARD®

LUPRON DEPOT®

LUPRON DEPOT-PED®

LIDODERM

LIDODERM®

MYOBLOC

MYOBLOC®

NEULASTA

NEULASTA®

NEUPOGEN

NEUPOGEN®

PEGYLATED INTERFERONS

PEGASYS®

PEGINTRON REDIPEN®

PEGINTRON®

PENLAC

CICLOPIROX

PENLAC®

PROVIGIL

PROVIGIL®

RAPTIVA

RAPTIVA®

REBIF

REBIF®

REGRANEX

REGRANEX®

REMICADE

REMICADE®

REVATIO

REVATIO®

RITUXAN

RITUXAN®

SOMAVERT

SOMAVERT®

SPORANOX

ITRACONAZOLE

SPORANOX®

STRATTERA

STRATTERA®

SYMLIN

SYMLIN®

SYMLINPEN 120®

SYMLINPEN 60®

SYNAGIS

SYNAGIS®

TAZORAC

TAZORAC®

TOPAMAX/ZONEGRAN

TOPAMAX®

ZONEGRAN®

ZONISAMIDE

TOPICAL TRETINOIN PRODUCTS

ATRALIN®

AVITA®

RETIN-A MICRO®

RETIN-A®

TRETINOIN

ZIANA®

VFEND

VFEND®

XOLAIR

XOLAIR®

ZYVOX

ZYVOX®

Index

ACTIQ/FENTORA

Affected Drugs

ACTIQ®

FENTANYL CITRATE

FENTORA®

Covered Uses

All FDA approved indications not otherwise excluded from Part D.

Exclusion Criteria

Breakthrough Chronic (Non-Cancer) Pain. Acute and/or postoperative pain including surgery/post-surgery, trauma/post-trauma, acute medical illness (acute abdominal pain, pelvic pain, muscle spasm). Pre-anesthesia (preoperative anxiolysis and sedation and/or supplement to anesthesia. Coverage is not recommended for circumstances not listed in the Covered Uses.

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

Breakthrough pain in Pts with cancer if Pt is unable to swallow, has dysphagia, esophagitis, mucositis, or uncontrollable nausea/vomiting OR Pt is unable to take 2 other short-acting narcotics (eg, oxycodone, morphine sulfate, hydromorphone, etc) secondary to allergy or severe adverse events AND Pt is on or will be on a long-acting narcotic (eg, Duragesic), or the Pt is on intravenous, subcutaneous, or spinal (intrathecal, epidural) narcotics (eg, morphine sulfate, hydromorphone, fentanyl citrate).

ALPHA-1 PROTEINASE INHIBITORS

Affected Drugs

ARALAST®

PROLASTIN®

ZEMAIRA®

Covered Uses

All FDA approved indications not otherwise excluded from Part D. Other phenotypes with an alpha1-antitrypsin serum concentration less than 11 microM (11 micromol/L) or 80 mg/dL (eg, PiSZ phenotype). AAT deficiency-associated panniculitis.

Exclusion Criteria

PiMZ or PiMS phenotype of alpha1-antitrypsin deficiency, unless alpha1-antitrypsin serum concentrations are less than 11 microM (11 micromol/L) or 80 mg/dL. Cystic fibrosis. COPD without alpha1-antitrypsin deficiency. Alpha1-antitrypsin deficiency without lung disease, even if deficiency-induced hepatic disease is present. Bronchiectasis (without alpha1-antitrypsin deficiency). Coverage not recommended for anything not listed under Covered Uses.

Required Medical Information

For AAT deficiency and emphysema of other phenotypes that are not FDA-approved (eg, PiSZ, PiMZ or PiMS phenotype), an alpha1-antitrypsin serum concentration of less than 11 microM (11 micromol/L) or 80 mg/dL is required.

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

For AAT deficiency and emphysema of other phenotypes that are not FDA-approved (eg, PiSZ, PiMZ or PiMS phenotype), an alpha1-antitrypsin serum concentration of less than 11 microM (11 micromol/L) or 80 mg/dL is required.

AMEVIVE

Affected Drugs

AMEVIVE®

Covered Uses

All FDA approved indications not otherwise excluded from Part D.

Exclusion Criteria

N/A

Required Medical Information

.

Age Restrictions

Greater than or equal to 16 years of age.

Prescriber Restrictions

Plaque psoriasis.Prescribed by a dermatologist.

Coverage Duration

Plaque psoriasis or PsA,12 wks of tx. May get 2nd 12 wks if other conditions met

Other Criteria

Plaque psoriasis.Patient has chronic (greater than or equal to 1 year) plaque psoriasis AND Patient has tried a systemic therapy (e.g.,MTX,azathioprine,cyclosporine,Soriatane,Prograf,Raptiva,Enbrel,Remicade, Cellcept,6-thioguanine, sulfasalazine,hydroxyurea,propylthiouracil, OR oral methoxsalen plus UVA light [PUVA]) for psoriasis. Rarely, a patient may have contraindications to nearly all of these other therapies and exceptions can be made on a case-by-case basis.

ANABOLIC STEROIDS

Affected Drugs

ANADROL-50®

OXANDRIN®

OXANDROLONE

Covered Uses

All FDA approved indications not otherwise excluded from Part D. Plus Oxandrin for inclusion body myositis (IBM) sporadic form. Oxandrin for ALS for maintenance/improvement in muscle strength and/or respiratory capacity. Oxandrin for quadriplegic/tetraplegic patients for maintenance/improvement in respiratory muslce strength, pulmonary function, and/or dyspnea. Oxandrin for Duchenne muscular dystrophy. Oxandrin for constitutional delay of growth or growth and puberty in prepubertal boys with psychosocial difficulties or psychological distress due to their condition. Oxandrin for girls (8 y/o and older) w/Turner's Syndrome or Ullrich-Turner Syndrome and concomitantly receiving growth hormone therapy. Oxandrin for management of protein catabolism w/burns or burn injury if patients have tried a beta-blocker or have a contraindication to beta-blocker use. Oxandrin for AIDS wasting and cachexia due to a chronic disease. Oxandrin for cachexia due to cancer. Anadrol-50 for prevention/prophylaxis of hereditary angioedema after the patient has tried danazol. Anadrol-50 for AIDS wasting and cachexia due to a chronic disease.

Exclusion Criteria

Coverage of Oxandrin AND Anadrol-50 is not recommended in the following circumstances: Management of weight loss. HIV-associated lipodystrophy. Chronkhite-Canada Syndrome. Heart failure in patients with idiopathic dilated cardiomyopathy (IDC), mitral regurgitation, or aortic regurgitation. Athletic performance (ability) enhancement. Coverage is not recommended for circumstances not listed in the Covered Uses.

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

Oxandrin for the management of protein catabolism associated with burns/burn injury if patient has tried a beta-blocker (e.g., propranolol, metoprolol) or patient has a contraindication to beta-blocker use. Anadrol-50 for prevention/prophylaxis of hereditary angioedema after the patient has tried danazol.

ARANESP

Affected Drugs

ARANESP®

Covered Uses

All FDA approved indications not otherwise excluded from Part D worded as anemia associated with CRF, including patients on dialysis and not on dialysis, if hemoglobin (Hb) is less than or equal to 11.0 g/dL for therapy initiation. If the patient has previously been receiving darbepoetin or epoetin alfa, approve only if Hb is less than or equal to 12.0 g/dL. Deny darbepoetin if hemoglobin exceeds 12.0 g/dL if previously receiving the product for this indication and in any situation (continuation or initiation). Anemia in cancer due to chemotherapy approve for 4 months if the patient has a Hb less than or equal to 10.0 g/dL or Hb is greater than 10.0 g/dL but less then or equal to 12.0 g/dL and the physician anticipates a Hb decrease or the patient has comorbidities that require higher Hb levels. Also, deny darbepoetin if Hb is greater than 12.0 g/dL if previously receiving the product for this indication and in any situation (continuation or initiation). Anemia due to myelodysplastic syndrome (MDS) but do not approve if Hb is greater than 12.0 g/dL if previously receiving the product for this indication and in any situation (continuation or initiation).

Exclusion Criteria

Anemia associated with cancer. Anemia associated with AML, CML or other myeloid cancers. Anemia associated with radiotherapy in cancer. To enhance athletic performance. Treatment of anemia in inflammatory bowel disease (eg, ulcerative colitis, Crohn's disease). Anemia in patients due to acute blood loss. Anemia in heart failure. Anemia associated with the use of ribavirin therapy for hepatitis C (in combination with interferon or pegylated interferon alfa 2a/2b products). Coverage not recommended for anything not listed under Covered Uses.

Required Medical Information

Hb value of less than or equal to 11.0 g/dL required for initiation of therapy in chronic renal failure (CRF). Also, in CRF Hb has to be less than or equal to 12.0 g/dL if previously receiving epoetin alfa or darbepoetin. CRF indication should be denied if Hb exceeds 12.0 g/dL for this condition and in any situation (continuation or initiation). For anemia in cancer patients due to chemotherapy a Hb of less than or equal to 10.0 g/dL is required or if Hb is greater than 10.0 g/dL but less than or equal to 12.0 g/dL the physician must anticipate a Hb decrease or the patient has comorbidities that require higher Hb levels. Deny darbepoetin in any situation that Hb is greater than 12.0 g/dL in cancer due to chemotherapy. For MDS, deny darbepoetin if hemoglobin is greater than 12.0 g/dL.

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

4 mos anemia in cancer pts d/t chemotherapy. Other indications x 12 mos, unless other specified

Other Criteria

Anemia due to myelodysplastic syndrome (MDS) but treatment with darbepoetin is not allowed if Hb greater than 12.0 g/dL at anytime point.

ARCALYST

Affected Drugs

ARCALYST®

Covered Uses

All FDA approved indications not otherwise excluded from Part D.

Exclusion Criteria

N/A

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

12 months

Other Criteria

N/A

AVONEX

Affected Drugs

AVONEX ADMINISTRATION PACK®

AVONEX®

Covered Uses

All FDA approved indications not otherwise excluded from Part D worded as patients with a diagnosis of MS or have experienced an attack and who are at risk of MS and prescribed by, or after consultation with, a neurologist or an MS-specialist.

Exclusion Criteria

Concurrent use of Rebif, Betaseron, Copaxone or Tysarbi. Coverage not recommended for anything not listed under Covered Uses

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

Prescribed by or after consultation with a neurologist or an MS specialist.

Coverage Duration

Authorization will be for 12 months.

Other Criteria

N/A

B vs D - Part B versus Part D Coverage PA

Affected Drugs

ANZEMET®

AZASAN®

AZATHIOPRINE

CARIMUNE NF NANOFILTERED®

CELLCEPT®

CESAMET®

CYCLOPHOSPHAMIDE

CYCLOSPORINE

CYTOXAN®

DRONABINOL®

EMEND®

ENGERIX-B®

FLEBOGAMMA®

GAMASTAN S-D®

GAMMAGARD LIQUID®

GAMUNEX®

GENGRAF

GRANISETRON HCL

GRANISOL®

IMURAN®

IVEEGAM EN®

KYTRIL®

MARINOL®

METHOTREXATE

MYFORTIC®

NEORAL®

OCTAGAM®

ONDANSETRON HCL

ONDANSETRON ODT

PANGLOBULIN NF®

PANGLOBULIN®

PHENERGAN®

POLYGAM S-D®

PROGRAF®

PROMETHAZINE HCL

RAPAMUNE®

RECOMBIVAX HB®

SANDIMMUNE®

TREXALL®

ZOFRAN ODT®

ZOFRAN®

Covered Uses

This drug may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the drug to make the determination.

BETASERON

Affected Drugs

BETASERON®

Covered Uses

All FDA approved indications not otherwise excluded from Part D worded as patients with a diagnosis of MS or have experienced an attack and who are at risk of MS and prescribed by, or after consultation with, a neurologist or an MS-specialist.

Exclusion Criteria

Concurrent use of Avonex, Rebif, Copaxone or Tysarbi. Coverage not recommended for anything not listed under Covered Uses.

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

Prescribed by or after consultation with a neurologist or an MS specialist.

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

N/A

BOTOX

Affected Drugs

BOTOX®

Covered Uses

All FDA approved indications not otherwise excluded from Part D. Plus Achalasia. Anal Fissure. BPH after a trial with at least 2 other therapies. Chronic facial pain/pain associated with TMJ dysfunction. Chronic low back pain if after trial of at least 2 other pharmacologic therapies AND if being used as part of a multimodal therapeutic pain management program. Plantar fasciitis. Tinnitus after a trial with at least 2 other pharmacologic therapies AND tinnitus retraining therapy AND prescribed by an ENT. Headache (migraine, chronic tension HA, whiplash, chronic daily HA) after trial with at least 2 other pharmacologic therapies AND prescribed by or in consultation with a neurologist or HA specialist. Palmar/plantar and facial hyperhidrosis after trial with at least 1 topical agent. Myofascial pain. Salivary hypersecretion. Spasticity (eg, due to cerebral palsy, stroke, brain injury, spinal cord injury, MS, hemifacial spasm). Essential tremor after a trial with at least 1 other pharmacological therapy. Dystonia other than cervical (eg, focal dystonias, tardive dystonia, anismus). Bladder/voiding/urethral dysfunction after trial with at least 1 other pharmacologic therapy. Gastroparesis after a trial with at least 1 promotility drug. Vaginismus after a trial with at least 2 other treatment options. Dysphagia. Interstitial cystitis. Frey's syndrome. Ophthalmic disorders (eg, esotropia, exotropia, nystagmus, facial nerve paresis). Speech/voice disorders (eg, dysphonias). Tourette's syndrome after a trial with at least 1 more commonly used pharmacologic therapy. Crocodile tears syndrome. Fibromyalgia after a trial of at least 2 commonly used pharmacologic therapies.

Exclusion Criteria

Cosmetic uses (eg, facial rhytides, frown lines, glabellar wrinkling, horizontal neck rhytides, mid and lower face and neck rejuvenation, platsymal bands, rejuvenation of the peri-orbital region. Allergic rhinitis. Gait freezing in Parkinsons disease. Coverage not recommended for anything not listed under Covered Uses.

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

Tinnitus if prescribed by ENT. Headache if prescribed by, or after consultation with, a neurologist or HA specialist.

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

Primary axillary hyperhydrosis after trial with at least 1 topical agent (eg, aluminum chloride). BPH after trial with at least 2 other therapies (eg, alpha1-blocker, 5 alpha-reductase inhibitor, TURP, transurethral microwave heat treatment, TUNA, interstitial laser therapy, stents, various forms of surgery). Chronic low back pain after trial with at least 2 other pharmacologic therapies (eg, NSAID, antispasmodics, muscle relaxants, opioids, antidepressants) and if being used as part of a multimodal therapeutic pain management program. Tinnitus after a trial with at least 2 other pharmacologic therapies (eg, lidocaine, antihistamines, antidepressants, anxiolytics, diuretics, anticonvulsants, antispastics) and tinnitus retraining therapy and prescribed by an ENT (eg, otolaryngologist). Headache (eg, migraine, chronic tension headache, whiplash, chronic daily headache) after a trial with at least 2 other pharmacologic therapies and prescribed by or after consultation with a neurologist/headache specialist. Palmar/plantar and facial hyperhidrosis after a trial with at least 1 topical agent (eg, aluminum chloride). Essential tremor after a trial with at least 1 other pharmacologic therapy (eg, primidone, propranolol, benzodiazepines, gabapentin, topiramate). Bladder/Voiding/Urethral dysfunction after a trial with at least 1 other pharmacologic therapy. Gastroparesis after a trial with at least 1 promotility drug (eg, metoclopramide, tegasterod, erythromycin). Vaginismus after a trial with at least 2 other treatment options (eg, behavior therapy, psychotherapy, biofeedback, dilatation techniques, deep muscle relaxation exercises, anesthetic creams, vaginal lubricants, propranolol, alprazolam). Interstitial cystitis after a trial with at least 1 other pharmacologic therapy (eg, pentosan polysulfate, heparin, antihistamines, TCAs, intravesical dimethyl sulfoxide, bacilli Calmette-GuTrin). TouretteÆs syndrome if after a trial with at least 1 more commonly used pharmacologic therapy (eg, neuroleptics, clonidine, SSRIs, psychostimulants). Fibromyalgia if after a trial of at least 2 or more commonly used pharmacologic therapies (eg, TCAs, SSRIs, SNRIs, dopamine agonists, and sedative hypnotics, or lidocaine injection into ôtrigger pointsö).

BYETTA

Affected Drugs

BYETTA®

Covered Uses

All FDA approved indications not otherwise excluded from Part D.

Exclusion Criteria

Weight loss treatment. Type 1 diabetes. Coverage not recommended for anything not listed under Covered Uses

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

N/A

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

Patient has inadequate glycemic control demonstrated on two-drug therapy (eg, metformin, sulfonylurea, thiazolidiedione).

CEREZYME

Affected Drugs

CEREZYME®

Covered Uses

All FDA approved indications not otherwise excluded from Part D. Type 1 Gaucher disease if being prescribed by, or after consultation with, a physician that specializes in the treatment of inherited metabolic disorders or the patient was referred to a center that specializes in the treatment of Gaucher disease. Type 2 or 3 Gaucher disease if the agent is being prescribed by, or after consultation with, a physician that specializes in the treatment of inherited metabolic disorders or the patient was referred to a center that specializes in the treatment of Gaucher disease.

Exclusion Criteria

Tay-Sachs disease. Coverage not recommended for anything not listed under Covered Uses

Required Medical Information

N/A

Age Restrictions

N/A

Prescriber Restrictions

Type 1, 2, or 3 Gaucher disease if prescribed by or after consultation with, a physician that specializes in the treatment of inherited metabolic disorders.

Coverage Duration

Authorization will be for 12 months, unless otherwise specified.

Other Criteria

N/A

CIMZIA

Affected Drugs

CIMZIA®

Covered Uses

All FDA approved indications not otherwise excluded from Part D.

Exclusion Criteria

Certolizumab pegol should not be given in comvination with anakinra. Rheumatoid arthritis (RA). Plaque psoriasis, Children with Crohn's disease. Coverage not recommended for anything not listed under Covered Uses.

Required Medical Information

N/A

Age Restrictions

Crohns disease in adults only.

Prescriber Restrictions

N/A

Coverage Duration

6 months

Other Criteria

Approve if patient has failed treatment with one or more conventional drugs (corticosteroids, Six MP, purinethol, azathioprine, or methotrexate) AND does not have a history of cancer as documented by a negative PPD test prior to initial treatment AND does not have a history of an autoimmune disease other than Crohns Disease.